Abstract
Since 1961 we have used the Spitzy operation combined with a vertical osteotomy of the outer cortex of the ilium for patients with arthritis secondary to acetabular dysplasia or subluxation. We present herein on the long-term results of a modified Spitzy shelf operation in 119 hips with a mean follow-up of 23.8 years. Preoperative osteoarthritic change, the age at operation and shelf height were important factors in determining the outcome. Of the 61 hips in the pre-stage and the initial stage of osteoarthritis, 87% had good long-term results, compared with 51% of 58 hips with advanced osteoarthritis. The correct technical procedure is essential. A graft placed too high is resorbed due to lack of loading, and a graft placed too low produces impingement on the femoral head and accelerates the degenerative changes. However, the relatively uncomplicated nature of the operation gives it an advantage over other pelvic osteotomies. The general considerations are also described.
